64624 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

64624, Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 64624
Description: Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed
Source: New Hampshire Precertification List, Pg 138 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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